Nightingale BSN 246 HESI RN Med - Surg proctored NAXLEX
NEWEST EXAM 2026 LATEST VERSION WITH REAL COMPLETE
QUESTIONS AND CORRECT DETAILED ANSWERS WITH
RATIONALES|| VERIFIED 100% ACTUAL FINAL EXAM WITH
VERIFIED ANSWERS & QUESTIONS || LATEST UPDATE 2026-
2027
A client with Crohn's disease is admitted to the medical unit with a
three-day history of abdominal cramping, nausea, and vomiting.
Which prescription should the nurse implement first?
A. Send the client to x-ray for a flat plate of the abdomen.
B. Give a prescribed analgesic for temperature above 101°F (38.3°C).
C. Place an indwelling urinary catheter and attach to a bedside
drainage unit.
D. Insert a nasogastric tube (NGT) and attach to low intermittent
suction.
Correct Answer : D
Sending the client to x-ray for a flat plate of the abdomen is important
for diagnosing the underlying cause of symptoms, such as bowel
obstruction or severe inflammation. However, in the immediate
situation, it is essential to relieve the client's symptoms and stabilize
their condition first.
Giving a prescribed analgesic for temperature above 101°F (38.3°C) can
help manage fever and pain. However, it is not the first priority. The
client's primary issue is abdominal cramping, nausea, and vomiting,
which need to be addressed urgently to prevent further complications.
Placing an indwelling urinary catheter and attaching it to a bedside
drainage unit may be necessary if there are urinary retention concerns.
However, this intervention does not directly address the gastrointestinal
symptoms that are currently most troubling for the client.
Inserting a nasogastric tube (NGT) and attaching it to low intermittent
suction is the most immediate priority. This action helps to decompress
the stomach, relieve nausea and vomiting, and prevent further
complications such as aspiration or worsening of the obstruction. It
provides immediate symptomatic relief and allows for better
management of the client's condition.
,The nurse is preparing to obtain a rapid coronavirus (COVID-19) test
for a client who was exposed to the virus eight days ago. The client is
experiencing fever, cough, and shortness of breath. Which action is
most important for the nurse to take?
A. Notify the charge nurse that the client will need assignment to the
COVID-19 specified area of the facility.
B. Place the nasal swab specimen for COVID-19 directly into a
biohazard bag.
C. Maintain a 6 feet (1.8 meters) distance from the client unless wearing
an N95 respirator and personal protective equipment (PPE) for droplet
precautions.
D. Start an intravenous infusion for an antiviral drug to be administered
for positive COVID-19 test results.
Correct Answer : C
Notifying the charge nurse that the client will need assignment to the
COVID-19 specified area of the facility is an important action for
infection control. However, the most immediate priority is to protect
oneself and others by maintaining appropriate distance and using PPE.
Placing the nasal swab specimen for COVID-19 directly into a biohazard
bag is necessary for safe specimen handling and to prevent
contamination. While important, it follows after ensuring that proper
PPE is used and distancing measures are maintained.
Maintaining a 6 feet (1.8 meters) distance from the client unless wearing
an N95 respirator and personal protective equipment (PPE) for droplet
precautions is the most crucial action. This step ensures the nurse's
safety and reduces the risk of virus transmission. Proper PPE and
distancing protocols are essential in managing a suspected COVID-19
case.
Starting an intravenous infusion for an antiviral drug to be administered
for positive COVID-19 test results is part of the treatment plan if the test
comes back positive. However, this step comes after ensuring safety
through proper use of PPE and maintaining distance from the client.
,The nurse completes the admission assessment of a client with
systemic lupus erythematosus. Which finding requires immediate
follow-up by the nurse?
A. Alopecia.
B. Haematuria.
C. Fatigue.
D. Joint pain.
Correct Answer : B
Alopecia, or hair loss, is a common symptom of systemic lupus
erythematosus but does not require immediate follow-up. It is not life-
threatening and can be managed as part of the overall treatment plan.
Haematuria, or blood in the urine, requires immediate follow-up
because it can indicate serious renal involvement or a possible flare-up
of lupus nephritis. Kidney complications in lupus can lead to severe
outcomes if not addressed promptly.
Fatigue is a common symptom of lupus and while it can significantly
impact the client's quality of life, it does not usually require urgent
intervention. It is managed through ongoing treatment and lifestyle
adjustments.
Joint pain is another common symptom of lupus. Although it can be
debilitating, it is not an emergency and can be managed through
standard treatments for lupus.
, A client with type 1 diabetes mellitus (DM) is admitted to the hospital
for an emergency cholecystectomy. The client explains to the nurse
about experiencing difficulty at home in keeping blood glucose
levels under 200 mg/dl (11.1 mmol/L). To prevent the client from
developing diabetic ketoacidosis (DKA), which intervention is most
important for the nurse to include in the plan of care?
A. Obtain a fingerstick glucose every 6 hours.
B. Ensure IV fluids are infusing continuously.
C. Test urine for the presence of ketones.
D. Teach the client how to manage sick day
Correct Answer : C
Obtaining a fingerstick glucose every 6 hours is important for
monitoring blood glucose levels and ensuring they are within the target
range. However, it is not the most critical intervention for preventing
diabetic ketoacidosis. Testing for ketones provides more specific
information on the development of DKA.
Ensuring IV fluids are infusing continuously is crucial for maintaining
hydration and preventing electrolyte imbalances, particularly in a client
who may be at risk for DKA. However, this intervention is supportive
and not as directly related to detecting the onset of DKA as testing for
ketones.
Testing urine for the presence of ketones is the most important
intervention. The presence of ketones indicates that the body is
breaking down fat for energy instead of using glucose, which is a
hallmark of diabetic ketoacidosis. Early detection of ketones allows for
prompt intervention to prevent the progression of DKA.
Teaching the client how to manage sick days is essential for long-term
diabetes management and preventing complications during illness.
However, for the immediate prevention of DKA in the hospital setting,
testing for ketones is more urgent and directly related to detecting and
managing the condition.
NEWEST EXAM 2026 LATEST VERSION WITH REAL COMPLETE
QUESTIONS AND CORRECT DETAILED ANSWERS WITH
RATIONALES|| VERIFIED 100% ACTUAL FINAL EXAM WITH
VERIFIED ANSWERS & QUESTIONS || LATEST UPDATE 2026-
2027
A client with Crohn's disease is admitted to the medical unit with a
three-day history of abdominal cramping, nausea, and vomiting.
Which prescription should the nurse implement first?
A. Send the client to x-ray for a flat plate of the abdomen.
B. Give a prescribed analgesic for temperature above 101°F (38.3°C).
C. Place an indwelling urinary catheter and attach to a bedside
drainage unit.
D. Insert a nasogastric tube (NGT) and attach to low intermittent
suction.
Correct Answer : D
Sending the client to x-ray for a flat plate of the abdomen is important
for diagnosing the underlying cause of symptoms, such as bowel
obstruction or severe inflammation. However, in the immediate
situation, it is essential to relieve the client's symptoms and stabilize
their condition first.
Giving a prescribed analgesic for temperature above 101°F (38.3°C) can
help manage fever and pain. However, it is not the first priority. The
client's primary issue is abdominal cramping, nausea, and vomiting,
which need to be addressed urgently to prevent further complications.
Placing an indwelling urinary catheter and attaching it to a bedside
drainage unit may be necessary if there are urinary retention concerns.
However, this intervention does not directly address the gastrointestinal
symptoms that are currently most troubling for the client.
Inserting a nasogastric tube (NGT) and attaching it to low intermittent
suction is the most immediate priority. This action helps to decompress
the stomach, relieve nausea and vomiting, and prevent further
complications such as aspiration or worsening of the obstruction. It
provides immediate symptomatic relief and allows for better
management of the client's condition.
,The nurse is preparing to obtain a rapid coronavirus (COVID-19) test
for a client who was exposed to the virus eight days ago. The client is
experiencing fever, cough, and shortness of breath. Which action is
most important for the nurse to take?
A. Notify the charge nurse that the client will need assignment to the
COVID-19 specified area of the facility.
B. Place the nasal swab specimen for COVID-19 directly into a
biohazard bag.
C. Maintain a 6 feet (1.8 meters) distance from the client unless wearing
an N95 respirator and personal protective equipment (PPE) for droplet
precautions.
D. Start an intravenous infusion for an antiviral drug to be administered
for positive COVID-19 test results.
Correct Answer : C
Notifying the charge nurse that the client will need assignment to the
COVID-19 specified area of the facility is an important action for
infection control. However, the most immediate priority is to protect
oneself and others by maintaining appropriate distance and using PPE.
Placing the nasal swab specimen for COVID-19 directly into a biohazard
bag is necessary for safe specimen handling and to prevent
contamination. While important, it follows after ensuring that proper
PPE is used and distancing measures are maintained.
Maintaining a 6 feet (1.8 meters) distance from the client unless wearing
an N95 respirator and personal protective equipment (PPE) for droplet
precautions is the most crucial action. This step ensures the nurse's
safety and reduces the risk of virus transmission. Proper PPE and
distancing protocols are essential in managing a suspected COVID-19
case.
Starting an intravenous infusion for an antiviral drug to be administered
for positive COVID-19 test results is part of the treatment plan if the test
comes back positive. However, this step comes after ensuring safety
through proper use of PPE and maintaining distance from the client.
,The nurse completes the admission assessment of a client with
systemic lupus erythematosus. Which finding requires immediate
follow-up by the nurse?
A. Alopecia.
B. Haematuria.
C. Fatigue.
D. Joint pain.
Correct Answer : B
Alopecia, or hair loss, is a common symptom of systemic lupus
erythematosus but does not require immediate follow-up. It is not life-
threatening and can be managed as part of the overall treatment plan.
Haematuria, or blood in the urine, requires immediate follow-up
because it can indicate serious renal involvement or a possible flare-up
of lupus nephritis. Kidney complications in lupus can lead to severe
outcomes if not addressed promptly.
Fatigue is a common symptom of lupus and while it can significantly
impact the client's quality of life, it does not usually require urgent
intervention. It is managed through ongoing treatment and lifestyle
adjustments.
Joint pain is another common symptom of lupus. Although it can be
debilitating, it is not an emergency and can be managed through
standard treatments for lupus.
, A client with type 1 diabetes mellitus (DM) is admitted to the hospital
for an emergency cholecystectomy. The client explains to the nurse
about experiencing difficulty at home in keeping blood glucose
levels under 200 mg/dl (11.1 mmol/L). To prevent the client from
developing diabetic ketoacidosis (DKA), which intervention is most
important for the nurse to include in the plan of care?
A. Obtain a fingerstick glucose every 6 hours.
B. Ensure IV fluids are infusing continuously.
C. Test urine for the presence of ketones.
D. Teach the client how to manage sick day
Correct Answer : C
Obtaining a fingerstick glucose every 6 hours is important for
monitoring blood glucose levels and ensuring they are within the target
range. However, it is not the most critical intervention for preventing
diabetic ketoacidosis. Testing for ketones provides more specific
information on the development of DKA.
Ensuring IV fluids are infusing continuously is crucial for maintaining
hydration and preventing electrolyte imbalances, particularly in a client
who may be at risk for DKA. However, this intervention is supportive
and not as directly related to detecting the onset of DKA as testing for
ketones.
Testing urine for the presence of ketones is the most important
intervention. The presence of ketones indicates that the body is
breaking down fat for energy instead of using glucose, which is a
hallmark of diabetic ketoacidosis. Early detection of ketones allows for
prompt intervention to prevent the progression of DKA.
Teaching the client how to manage sick days is essential for long-term
diabetes management and preventing complications during illness.
However, for the immediate prevention of DKA in the hospital setting,
testing for ketones is more urgent and directly related to detecting and
managing the condition.
